Provider Demographics
NPI:1194943811
Name:BERNARD, GLENNA LEE - (MS, APRN-BC, AE-C)
Entity type:Individual
Prefix:
First Name:GLENNA LEE
Middle Name:-
Last Name:BERNARD
Suffix:
Gender:F
Credentials:MS, APRN-BC, AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8054 INVERNESS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4011
Mailing Address - Country:US
Mailing Address - Phone:301-299-3014
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MARYLAND HEALTH CTR
Practice Address - Street 2:BUILDING 140, CAMPUS DRIVE
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20742-0001
Practice Address - Country:US
Practice Address - Phone:301-314-8162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR099191163WC1400X
DCRN964675364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC1400XNursing Service ProvidersRegistered NurseCollege Health
Not Answered364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health